Chitosan: A natural substitute of EDTA solution for final irrigation in endodontics treatment.

BACKGROUND: The purpose of this study was to assess the quantity of the chelated calcium ions and the smear layer removal efficiency after root canal final irrigation with three different solutions. MATERIALS AND METHODS: Forty-five teeth were instrumented with rotary-files, then randomly divided into 3 equal groups (n = 15) depending on the final irrigation solution; group I: 17% ethylenediaminetetraacetic acid (EDTA), group II: 0.2% chitosan, and group III: 10% trisodium citrate. According to the time of application, every group was divided into 3 subgroups (1 min, 5 min, and 24 h). The quantification analysis of chelated calcium ions was performed by flame atomic absorption spectrometry (FAAS). Then, the presence of smear layer was examined by splitting the samples longitudinally and using scanning electron microscopy (SEM) to examine coronal, middle, and apical root canal levels. One-way analysis of variance (ANOVA) test was used for the evaluation of treatment effect. Kruskal-Wallis test was executed to detect a significant difference between groups, while Mann-Whitney U test has determined the difference between each two groups for smear layer. RESULTS: Both 17% EDTA and 0.2% chitosan had not been statistically significant difference for smear layer removal efficiency and observed calcium ion concentrations. Although, they were more efficient of 10% trisodium citrate with a significant difference (P < 0.05). CONCLUSION: The application time of the chelators' solutions must not exceed 5 min to completely remove smear layer, and 0.2% chitosan is a natural substitute for 17% EDTA with a safety application for 24 h.

Welfare implications of invasive piglet husbandry procedures, methods of alleviation and alternatives: a review.

Iron administration, teeth clipping, tail docking and castration are common invasive husbandry procedures performed on piglets on commercial farms, generally within the first week of life. These procedures are performed to prevent potential health and welfare problems of piglets and/or the sow, or, with respect to castration, to enhance meat quality. The objectives of this review were firstly, to provide the rationale and scientific evidence for performing these procedures, secondly, to describe the welfare implications of these procedures, and lastly, to describe mitigation strategies or alternatives that can be used to eliminate or reduce the pain caused by these procedures. Administering supplementary iron is necessary to prevent anaemia in piglets and the procedure has a low welfare impact. The stated benefits of teeth clipping to prevent udder lesions do not appear to outweigh the risk from injury and infection in piglets following the procedure. Tail docking reduces the prevalence of tail biting, but does not eliminate this behaviour and the practice of tail docking can cause acute pain. Castration is primarily performed to reduce the occurrence of boar taint, but alternatives are now available that negate the need to perform this procedure. Teeth clipping, tail docking and castration all cause behavioural and physiological changes indicative of acute pain and can have potentially long-term negative consequences such as causing abscesses, lesions and the formation of neuromas. Therefore effective pain mitigation strategies (e.g. analgesia, local or general anaesthesia) that markedly alleviate the pain caused by these procedures are necessary to improve the welfare of piglets. Alternatively, if management practices are available that eliminate the need for performing these procedures altogether, then they should be adopted.

Ritual tooth modification among the Baka pygmies in Cameroon.

INTRODUCTION: Ritual tooth mutilation is a relatively understudied human body mutilatory practices. The purpose of the study was to examine the effects of ritual tooth modification, teeth cleaning measures and herbal medications for their oral health problems among the Baka pygmies in Cameroon. MATERIALS AND METHODS: This cross-sectional study was conducted between January and March, 2012 using semi-structured questionnaire as the tool of data collection. Intra-oral examinations were carried out to determine the dental hard tissue loss using Smith and Knight Tooth Wear Index (TWI). RESULTS: Fifty-six pygmies with ritual tooth modification made of 34 males (60.7%) and 22 females (39.3%) with a mean age of 31 years were interviewed and had oral health examination. The reported age at which the tooth modification was done was between 10 and 15 years with mean age as 12 ± 1.66 years. More than half (58.9%) of the participants reported the tooth filing as painful and nearly two-thirds (64.3%) of the participants reported having persistent pain afterwards. The upper right central and lateral incisors were the most commonly modified teeth. A total of 42.9%, 12.5% and 7.1% of the participants had Smith and Knight TWI scores of 2, 3 and 4 respectively. All the participants reported cleaning their teeth at least once-daily with about two-thirds (66.1%) of them doing so with chewing stick. The majority (67.9%) of the participants reported cleaning their teeth for cosmetic reasons [to remove dirt' (60.7%) and 'to remove stains' (7.1%)]. The oral health problems among the participants in form of tooth sensitivity, toothache and dental abscess were treated with plant-based traditional medicines from Irvingia gabonensis, Ricinodendron heudoletti, Pterocarpus soyauxii, Alchornea cordifolia and Piptadeniastrum africanum. CONCLUSION: Ritual tooth modification is a painful mutilatory practice which is culturally significant for the Baka pygmies without health benefit. There is need for intervention to stop this harmful traditional practices among the pygmies. Further studies is recommended to elucidate the medicinal and pharmaceutical benefits of plants used for tooth sensitivity and other oral health problems by the pygmies.

Er:YAG 2,940-nm laser fiber in endodontic treatment: a help in removing smear layer.

Cleaning and disinfection of the root canal system are some of the most important goals in endodontic therapy. The aim of this preliminary study is to assess the effectiveness of Er:YAG laser fiber in removing the smear layer produced during root canal walls instrumentation. Forty-eight single-rooted teeth were prepared with manual and rotary Ni-Ti instruments, in addition to 2.5% NaOCl irrigation. Samples were randomly subdivided into groups and treated with: three irradiations of 5 s each, with 300-µm Er:YAG endodontic fiber, 1 W and 2.5% NaOCl solution (A Group); two laser irradiations with 17% EDTA solution and 2.5% NaOCl solution (B Group); laser irradiation plus 17% EDTA solution and 2.5% NaOCl (C Group); only in the final wash of 17% EDTA (control group D). During laser treatment, temperature variations were analyzed by using thermocouple and thermal camera devices in order to test both deep and superficial temperatures. Each sample was finally observed by scanning electron microscope (SEM) at the coronal, medium, and apical thirds at ×500 magnification and blindly scored depending on the amount of smear layer. Statistical analysis of the results was conducted using the Kruskal-Wallis and Mann-Whitney test to determine the eventual significant differences between the quantity of smear layer in each group and between the groups at coronal, medium, and apical third: a p value <0.05 was considered significant. The thermal analysis realized by thermocouple with the used parameters demonstrated that laser endodontic fiber produces an average deep temperature increase of 3.5 ± 0.4 °C; analysis performed with a thermal camera showed an average superficial temperature increase of 1.3 ± 0.2 °C produced by laser endodontic fiber use. Deep and superficial temperatures fall immediately after irradiation possibly without causing structural damage or anatomical alteration inside the root canal and neither on periodontal tissues. SEM analysis showed that specimens of group B had the highest level of cleaning in every third, with a significant difference with groups D and A; group C samples showed a good percentage of cleaned tubules in apical and middle thirds, while group D teeth showed open dentinal tubules in coronal third, with a statistical difference with group A samples which were the worst cleaned. The Er:YAG fiber double irradiation with EDTA 17% and NaOCl 2.5% has been demonstrated to be effective in removing smear layer, even in the apical third which is described as the hardest area to clean during endodontic treatment.

[Pain management in dentistry].

The aim of the study was to determine the most effective dose of Ibuprofen - one of the non-steroidal anti-inflammatory drugs frequently used in dental practice for pain management. According to our observations, Ibuprofen markedly softens and quickly reduces procedural pain in 55 (91.67%) patients and post-procedural pain in 44 (73.33%) patients, reduces the post-procedural need for or the amount of the drug, removes the fear of anesthesia and endodontic treatment; with irreversible pulpits significantly increases the efficiency of the inferior alveolar nerve block by local anesthetics. Our clinical observation of taking ibuprofen pre-procedurally demonstrates its effectiveness not only as a means for the relief of pain episodes, but also as an excellent anti-inflammatory treatment for chronic toothache Based on our research, the appointment of non-steroidal anti-inflammatory drugs before dental interventions, in this case - Ibuprofen turned out to be the key to the success of effective pain management. We suggest that administration of analgesics in order to relieve and effectively pre-empt pain before, during or after treatment should start before surgery and furthermore, this treatment should be extended into the postoperative period. Premedication with ibuprofen significantly increased the success rates of inferior alveolar nerve block anesthesia in teeth with irreversible pulpitis.

Bacteriologic features and antimicrobial resistance of organisms associated with extracted teeth: findings from a Nigerian university teaching hospital.

BACKGROUND: Empirically prescribed antibiotics are widely employed in the management of odontogenic infections. OBJECTIVE: To characterise the infections associated with extracted teeth and assess effectiveness of the antibiotics prescribed empirically following tooth extraction. METHODS: The study was cross-sectional and consisted of 41 consecutively recruited subjects who required extraction for infections associated with the tooth. Appropriate clinical specimens were collected aseptically from each patient and transported in Stuart's transport medium for processing in the laboratory. Isolation, identification, and susceptibility pattern of anaerobic and facultative organisms were done employing standard bacteriologic techniques. Antimicrobial susceptibility testing was performed by the disc diffusion technique. RESULTS: There were positive cultures for 37 patients. Twenty-eight aerobic (45.9%) bacteria and 32 anaerobic (54.1%) bacteria were isolated, an approximation of two microorganisms per patient. Staphylococcus was the most predominant aerobe (25.0%) whereas Bacteroides fragilis was the most predominant anaerobe (34.2%). All the bacteria isolated showed in vitro resistance to cephalexin, cloxacillin and metronidazole. Eighteen (64.3%) different aerobic bacteria and 13 (40.6%) different anaerobic bacteria were sensitive to ciprofloxacillin and these included staphylococcus and Bacteroides fragilis. Sensitivity pattern for amoxycillin was very poor with 3.6% and 6.3% for aerobes and anaerobes respectively. CONCLUSION: Odontogenic infections from our centre are polymicrobial in nature with anaerobes predominating. High resistance to most of the antibiotics routinely prescribed in our centre is common. Ciprofloxacillin demonstrated the highest sensitivity pattern.

Water flow on erbium:yttrium-aluminum-garnet laser irradiation: effects on dental tissues.

Since lasers were introduced in dentistry, there has been considerable advancement in technology. Several wavelengths have been investigated as substitutes for high-speed air turbine. Owing to its high absorbability in water and hydroxyapatite, the erbium:yttrium-aluminum-garnet (Er:YAG) laser has been of great interest among dental practitioners and scientists. In spite of its great potential for hard tissue ablation, Er:YAG laser effectiveness and safety is directly related to an adequate setting of the working patterns. It is assumed that the ablation rate is influenced by certain conditions, such as water content of the target tissue, and laser parameters. It has been shown that Er:YAG irradiation with water coolant attenuates temperature rise and, hence, minimizes the risk of thermally induced pulp injury. It also increases ablation efficiency and enhances adhesion to the lased dental tissue. The aim of this review was to obtain insights into the ablation process and to discuss the effects of water flow on dental tissue ablation using Er:YAG laser.

Bone structure regeneration after low induction magnetic field treatment in teeth chosen for extraction.

PURPOSE: The aim of the work was to use and to evaluate the usefulness of the slow variable magnetic fields to aid the treatment of the teeth chosen for extraction. The marginal paradontium of periapical bone of teeth was in a state of extensive destruction. The teeth were chosen for extraction. MATERIAL AND METHODS: 13 patients were chosen. 10 of them had with endo-perio changes and 3 suffered from full tooth luxation and had the teeth replanted. Those people were to have an extraction procedure or were declared as impossible to treat in other dental offices. Patients underwent non-aggressive skaling, endodontic treatment and were exposed to slow variable magnetic fields generated by Viofor JPS, accordingly to methods and parameters suggested by Department of Propaedeutics in Dentistry of Pomeranian Medical University in Szczecin. The process of healing of changes was evaluated radiologically. RESULTS: RTG done after 2 weeks and after 2 months were evaluated in respect of bone regeneration. They show the bone structure concentration. A RTG evaluation after half a year, two and three years show a preservation of the bone structure concentration. CONCLUSIONS: The use of slow variable magnetic fields contributed to bone structure regeneration and to preserve teeth with recorded endo-perio syndrome. Endodontic treatment of replanted teeth, aided with magnetostimulation has stopped the osteolisis process.

Comparison of sedative effects of romifidine following intravenous, intramuscular, and sublingual administration to horses.

OBJECTIVE: To compare sedative effects of romifidine following IV, IM, or sublingual (SL) administration in horses. ANIMALS: 30 horses that required sedation for routine tooth rasping. PROCEDURE: Horses (n = 10/group) were given romifidine (120 microg/kg) IV, IM, or SL. Heart rate, respiratory rate, head height, distance between the ear tips, thickness of the upper lip, response to auditory stimulation, response to tactile stimulation, and degree of ataxia were recorded every 15 minutes for 180 minutes. Tooth rasping was performed 60 minutes after administration of romifidine, and overall adequacy of sedation was assessed. RESULTS: IV and IM administration of romifidine induced significant sedation, but SL administration did not induce significant sedative effects. Scores for overall adequacy of sedation after IV and IM sedation were not significantly different from each other but were significantly different from scores for horses given romifidine SL. Sedative and other effects varied among groups during the first 60 minutes after drug administration; thereafter, effects of IV and IM administration were similar. CONCLUSIONS AND CLINICAL RELEVANCE: Onset of action was fastest and degree of sedation was greater after IV, compared with IM, administration of romifidine, but duration of action was longer after IM administration. Sublingual administration did not result in clinically important sedative effects.

The effectiveness of acupuncture in treating acute dental pain: a systematic review.

OBJECTIVE: Acupuncture is frequently advocated as an effective treatment of dental pain. The question whether or not it is effective for this indication remains controversial. The aim of this systematic review therefore was to assess the effectiveness of acupuncture in dental pain. DATA SOURCES: Four electronic databases were searched: Medline, Embase, CISCOM, and the Cochrane Library. Only controlled trials were included in this review. DATA EXTRACTION: Information was extracted from included studies and entered on standard forms independently by both authors. Methodological quality was assessed using the Jadad score. MAIN RESULTS: 16 such studies were located. The majority of these trials imply that acupuncture is effective in dental analgesia. However, important questions remain unanswered. CONCLUSION: It is concluded that acupuncture can alleviate dental pain and that future investigations should define the optimal acupuncture technique and its relative efficacy compared with conventional methods of analgesia.

Minimal morbidity in outpatients undergoing oral surgical procedures under general anaesthesia in the dental surgery.

Economic pressures have resulted in an increased demand for surgical treatment under general anaesthesia on an outpatient basis. Previous studies have reported a high incidence of severe morbidity associated with general anaesthesia in both general dentistry and oral surgery. This is particularly marked with dento-alveolar procedures. The ready availability of relatively inexpensive monitoring equipment together with upgraded standards recently announced by various authorities necessitates that all practitioners review their current practices in the areas of sedation and general anaesthesia. In addition to the ultimate importance of patient care and safety, the increased incidence of litigation leaves no latitude for complacency. This paper details a relatively simple, cost-effective general anaesthetic technique suitable for outpatient oral surgical procedures in the dental surgery in which all relevant recommendations at the time of writing were observed or exceeded. Associated morbidity was considerably less than previously reported, with a high degree of patient satisfaction.

Microsurgical correction of the injured inferior alveolar nerve.

The pathology of inferior alveolar nerve injuries is discussed and the general and special guidelines for microsurgical reconstructive procedures are presented. Twenty-three cases are summarized: 22 cases showed marked restoration of nerve function after surgery.